title: What are the true costs of major trauma?
abstract: BACKGROUND
  This economic evaluation reports the results of a detailed study of the cost of major trauma treated at Princess Alexandra Hospital (PAH), Australia.
  
  
  METHODS
  A bottom-up approach was used to collect and aggregate the direct and indirect costs generated by a sample of 30 inpatients treated for major trauma at PAH in 2004. Major trauma was defined as an admission for Multiple Significant Trauma with an Injury Severity Score>15. Direct and indirect costs were amalgamated from three sources, (1) PAH inpatient costs, (2) Medicare Australia, and (3) a survey instrument. Inpatient costs included the initial episode of inpatient care including clinical and outpatient services and any subsequent representations for ongoing-related medical treatment. Medicare Australia provided an itemized list of pharmaceutical and ambulatory goods and services. The survey instrument collected out-of-pocket expenses and opportunity cost of employment forgone. Inpatient data obtained from a publically funded trauma registry were used to control for any potential bias in our sample. Costs are reported in Australian dollars for 2004 and 2008.
  
  
  RESULTS
  The average direct and indirect costs of major trauma incurred up to 1-year postdischarge were estimated to be A$78,577 and A$24,273, respectively. The aggregate costs, for the State of Queensland, were estimated to range from A$86.1 million to $106.4 million in 2004 and from A$135 million to A$166.4 million in 2008.
  
  
  CONCLUSIONS
  These results demonstrate that (1) the costs of major trauma are significantly higher than previously reported estimates and (2) the cost of readmissions increased inpatient costs by 38.1%.
authors.affiliation: University of Queensland, the School of Economics, Australian Centre for Economic Research on Health, Australian Centre for Pre-hospital Research, Queensland Ambulance Service, Queensland Health, The Princess Alexandra Hospital, Brisbane, Queensland, Australia. d.rowell@uq.edu.au
authors.forename: David
authors.initials: D
authors.lastname: Rowell
authors.forename: Luke
authors.initials: L
authors.lastname: Connelly
authors.forename: Jodie
authors.initials: J
authors.lastname: Webber
authors.forename: Vivienne
authors.initials: V
authors.lastname: Tippett
authors.forename: David
authors.initials: D
authors.lastname: Thiele
authors.forename: Michael
authors.initials: M
authors.lastname: Schuetz
mesh_terms: D000328:Adult; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000191:economics* / Q000628:therapy; D011793:Queensland; D012189:Retrospective Studies; D014193:Trauma Centers / Q000191:economics*